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002493 (SFD)f A' 4. P.O. BOX 1504 No. 002493 Building 78-105 CALLE ESTADO Address 18-545 Bott3kblush Dr. LA QUINTA, CALIFORNIA 92253 Owner- P'Ck. 'M OMWOm1'QG BUILDING: TYPE CONST. OCC: GRP. Mailing Address P.O. B= 2283 A.P. Number 617-382-M4 City Zip T el. � 92202 5"2228 Legal Description 54 Contractor Project Description s ie f midiv &Oeu .m Address . ' City "JZip Tela ' SaM State Lic. City MIG 1649 & Classif. 397169 Lic. # 202 Sq. Ft. CM 525 No. No. Dw. Stories Units ..Arch., Engr., ... ... .. .G�7u Size Designer New Add ❑ Alter ❑ Repair O Demolition ❑ Address Tel. City Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division,3'of,the'Businesss and,Proofessions Code, and my license is in full force ander.. effect.`1 © sr%%ft`i !�'��2/\_ - % .C. ..a p' - SIGNATURE / f' DATE OWNER -BUILDER DECLARATION • I hereby affirm that I am exempt from the Contractor's License Law for the following Estimated Valuation reason: (Sec. 7031.5,Business and Professions.Code: Any city or county which requires a Q[7tC"i.LaUU permit to construct, alter, improve, demolish, or epair any structure, prior to its issuance also -AMOUNT r requires the applicant for such permit to file a signed statement that he Is licensed pursuant to PERMIT - - - the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of Division 3 of the Business and' Profession's Code, or that. he is exempt' therefrom, and the basis /or thealleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit Plan Chk. Dep. - subjects.the applicant to a civil penalty of not more than live hundred dollars ($500). Pian Chk. Bal. ❑ I, as owner of the properly, or my employees with wages as their sole compensation, will r • IS do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and COnSt. 3�4 Professions Code: The Contractor's License Law does not apply to an owner of property who • builds or improves thereon and who does such work himself or -through his own employees, -MeCh. 3;, 00 provided that such improvements are not Intended or offered loi sale. If, however, the building • 00 or improvement is sold within one year of completion, the owner -builder will have the burden ElectricalA Of proving that he did not build or improve for the purpose of sale.) 7t � - +12 ❑ I, as owner of the property, am exclusively contracting with licensed contractors to -con- Plumbing 89.0 struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law ..- t p�C does not apply to an owner of property who builds or Improves thereon, and who contracts for - S.M.I. LI.M; such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) - Grading ;'0.00 C1 am exempt under Sec. B. 8 P.C. for this reason Driveway Enc. 20.00 Date owner Infrastructure 1.302.01 Frisk UZ Wd 68.87 i WORKERS' COMPENSATION DECLARATION I hereby affirm that'I have a certificate of consent to self -insure, or a certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) I Policy No. Company ❑ Copy is filed with the city. ❑ Certified copy is hereby furnished. _ TOTAL 2,,312.24 CERTIFICATE OF EXEMPTION FROM REMARKS WORKERS' COMPENSATION INSURANCE — (This section need not be completed if the permit is for one hundred dollars ($100) valuation or less.) - - I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date Owner NOTICE TO APPLICANT., If, after making this Certificate of Exemption you should become BY: subject to the Workers' Compensation provisions of the Labor Code,you must forthwith comply with such provisions or this permit shall be deemed revoked. .ZONE: _ Minimum Setback Distances: Front Setback from Center Line - Rear Setback from Rear Prop. Line CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Side Setback from Property Line Lender's Name Lender's Address ' FINAL DATE INSPECTOR This is a building permit when properly filled out,'signed and validated, and is subject to expiration it work thereunder is suspended for 180 days.r-2�--$permit I that I have certify read this application and state that the above information is correct. _ Issued by: Date I agree to comply with all city and county ordinances andpstate laws,relating to building' - construction, and hereby authorizerepresentatives of this city to enter the above- mentioned property for inspection purposes. _ _ Validated by: Signature of applicant Mailing Address Validation: City, State, Zip A 6 0 4 9 7 25 21224 CK HARD COPY CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ UNITS A.C. UNIT COLL. AREA LAB GRADE YARD SPKLR SYSTEM 2ND FL. SQ. FT. ROUGH PLUMB. BONDING HEATING (ROUGH) MOBILEHOME SVC. BAR SINK POR. SQ. FT. ® SEPTIC TAj j4r GAR. SQ. FT. ® POWER OUTLET ROOF DRAINS FOUND. REINF. DRAINAGE PIPING CAR P. SQ. FT. ® METER LOOP HEATING (FINAL) WALL SQ. FT. ® �jZREINF. STEEL DRINKING FOUNTAIN SQ. FT. ® GAS (FINAL) URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES FINAL INSP. WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LUMBER GR. LAUNDRYTRAY AIR HANDLING UNIT CFM FRAMING rG� /3 _ KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET COMPRESSOR HP POLE, TEM/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SQ. FT. ® c BATH TUB SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 1+/. c SEWAGE DISPOSAL SQ.FT.GAR ® 3/.c HOUSE SEWER SPARK ARRESTOR GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR �L14/SETBACK UND -7NIIA UNDERGROUND A.C. UNIT COLL. AREA LAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEPTIC TAj j4r ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP./EQUIP. �jZREINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ -$ LUMBER GR. FINAL INSP. FRAMING rG� /3 _ FINAL INSP. ROOFINGREMARKS: 17A- U !keit/A/47 Z /� N� / [ ,t VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH / tlLATION/SOUN[;/O L FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL gV i 0 -.z F -S 0 O'cy t, Aa-